Q I'm worried by all the publicity about HRT. The thing is that I can hardly function without it. I started HRT two years ago when I was getting such bad hot flushes that I had to leave work meetings to recover from them. I am so much better on the HRT, but the recent publicity about breast cancer has scared me witless. I really don't know what to do. What do you advise?

A HRT is obviously a Heavenly Respite from Torture for you. The menopause means our ovaries shut up shop and stop pumping out oestrogen. Falling oestrogen levels can cause hot flushes, night sweats and dry vaginas - all of which can play havoc with your work, home and sex life. Nothing works as well as HRT.

But it is true that there have been two excellent, large studies recently that have reinforced concerns that already existed about long-term use of HRT. It used to be thought that it was only the oestrogen in HRT that increased the risk of breast cancer. But the Million Women Study has shown that combined preparations that include the hormone progestogen increase the risk more than oestrogen alone. You need the progestogen to protect the womb from uterine cancer if you take oestrogen.

The bottom line is that if you monitor 1,000 50-year-old women for 10 years, 20 will get breast cancer if they don't take HRT, 25 will get it if they use oestrogen-only HRT and 39 will be diagnosed if they use oestrogen-progestogen combinations. That still means that 96% of women like you who use combined HRT won't get breast cancer. And your increased risk compared to a non-HRT user is only 1.9% over 10 years. Once you come off it, your risk starts to go back to that of a non-HRT user straight away and after five years, you have no increased risk at all.

The large American study, the Women's Health Initiative, which was stopped in July 2002 because of the increased incidence of breast cancer among HRT users, has cast substantial doubt on the many claimed benefits of HRT. The WHI found that HRT doesn't particularly help against heart disease, dementia or loss of concentration and mental abilities.

Taking HRT doesn't make you more or less likely to die before someone who doesn't take it. Statistically, it's neither a killer nor a panacea. If you want to take it for your hot flushes, then take the lowest possible dose of oestrogen to control your symptoms. You can cut oestrogen patches into smaller pieces and experiment until you find the size that suits you. To protect your womb, you can have a Mirena coil fitted, which releases small amounts of progestogen into the womb with minimal impact on the rest of your body. There is not yet a large study to prove that this combination of smallest doses of oestrogen and Mirena is safer than conventional HRT, but it makes sense to keep doses to a minimum.

Is tanned skin stronger?

Q We are off on holiday to Spain tomorrow. My kids, who are normally quite pale, have turned golden brown during the heatwave. Does this mean that they're now protected from burning and can I ease up on my usual rule of T-shirts and sunblock?

A Your kids' skin type has not changed. Once fair, always fair - even if you do have a golden tan. Their potential to burn in strong sun remains and I suggest you stick to your normal routine.

Dermatologists don't recognise tanning as a positive thing and say that any change in your natural colour as a result of sun represents skin damage. Most adults choose to take dermatologists' admonishments with a pinch of salt but kids need to be protected from our lifestyle choices and shouldn't be exposed to a hot midday sun or be allowed to burn.

My little girl has acne

Q For the past year my seven-year-old daughter's nose has been covered in small, greasy spots. I am puzzled as to why this should be happening. As a teenager I suffered quite badly with spots, but could it be that she is showing signs of puberty at such an early age?

Her diet is relatively healthy for a seven-year-old with plenty of fruit and vegetables and no fizzy drinks, but of course she has sweets, although not an excessive amount. Have you any ideas on what could be causing these spots?

A You noticed your daughter's greasy spots when she was six so it is highly unlikely that it is related to puberty. The greasy spots are due to sebum production, the naturally occurring cleanser, moisturiser and toner. Some of us make more than others and when pores become clogged with sebum, small spots can crop up. Diet is unlikely to be affecting her skin but obviously in the fight against junk food, you may not want to tell her that bit. I would avoid commercial cleansers or medicated soaps, which can irritate a child's skin - children really need only need to wash their faces with water.

I would be inclined not to focus her attention on her skin unless she brings it to your attention. If it becomes a social liability for her, your GP will refer you to a dermatologist.

· These answers are intended to be as accurate and full as possible, but should never be used as a substitute for seeking medical help. If you have a question for Dr Robinson, email drann@dircon.co.uk or write to her c/o The Health Editor, The Guardian, 119 Farringdon Road, London EC1R 3ER. She regrets that she cannot enter into personal correspondence.